Original articleCircumferential Versus Longitudinal Systolic Function in Patients with Hypertension: A Nonlinear Relation
Section snippets
Study Population
In all, 126 consecutive patients, aged 16 years or older, affected by stage II to III arterial hypertension, and having visited our echocardiography laboratory for a general evaluation of cardiovascular risk, were retrospectively included in this study. Patients were excluded if they had any of the following: evidence of secondary hypertension by extensive clinical, laboratory, and instrumental examinations; 2+ or greater mitral regurgitation; aortic regurgitation; any degree of valvular
Curve Fitting Analysis
The main characteristics of the study population are shown in Table 1. Nonlinear regression analysis showed that the relations of mFS and ScmFS (Figure 1) to AVPD and Sm were all best fitted by an inverse exponential function, a mathematic equivalent of the S-function previously used by Emilsson et al29 to describe the relation of EF to AVPD. Compared with the linear models (mFS = 10.25 + 0.53. AVPD, R = 0.45, P < 0.0001; mFS = 12.71 + 0.50 Sm, R = 0.40, P < 0.0001; ScmFS = 50.08 + 3.24. AVPD, R
Discussion
This study is the first to explore the relation between circumferential midwall and longitudinal LV systolic function in patients with hypertension. Our results indicate that in these patients: (1) a nonlinear relation between circumferential and longitudinal LV systolic indices exists; (2) systolic impairment occurs earlier in longitudinal than circumferential performance, even when the latter is assessed at the midwall; and (3) the nonlinearity of this relation is dependent on the effect of
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